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  • Title: Multifocal blue-on-yellow visual evoked potentials in early glaucoma.
    Author: Klistorner A, Graham SL, Martins A, Grigg JR, Arvind H, Kumar RS, James AC, Billson FA.
    Journal: Ophthalmology; 2007 Sep; 114(9):1613-21. PubMed ID: 17822971.
    Abstract:
    OBJECTIVE: To determine the sensitivity and specificity of blue-on-yellow multifocal visual evoked potentials (mfVEPs) in early glaucoma. DESIGN: Cross-sectional study. PARTICIPANTS: Fifty patients with a confirmed diagnosis of early glaucoma and 60 normal participants. METHODS: Black-and-white mfVEPs and blue-on-yellow mfVEPs were recorded using the Accumap version 2.0 (ObjectiVision Pty. Ltd., Sydney, Australia). All patients also underwent achromatic standard automated perimetry (SAP). MAIN OUTCOME MEASURES: Multifocal VEP amplitude and latency values in glaucoma patients were analyzed and compared with those of the normal controls. RESULTS: Based on the definition of visual field defect, in the group of glaucomatous eyes with SAP defects, amplitude of blue-on-yellow mfVEP was abnormal in all 64 cases (100% sensitivity), whereas black-and-white mfVEP missed 5 cases (92.2% sensitivity). Generally, larger scotomata were noted on blue-on-yellow mfVEP compared with black-and-white mfVEP for the same eyes. There was high topographic correspondence between SAP and amplitude of blue-on-yellow mfVEP and significant (P<0.0001) correlation between them (correlation coefficient, 0.73). Abnormal amplitude was detected in 3 of 60 eyes of control subjects (95% specificity). There was, however, no correlation between visual field defect and latency delay in glaucoma patients. Although there was a significant difference between averaged latency of control and glaucoma eyes, values considerably overlapped. CONCLUSIONS: The blue-on-yellow mfVEP is a sensitive and specific tool for detecting early glaucoma based on amplitude analysis.
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